172 174MainApplication

J. VERIFICATION AND AUTHORIZATION | SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT’S VERIFICATION I hereby certify that the above statements made by me and the information contained in the papers submitted in connection with this application are true. I am aware that if any of the foregoing statements are willfully false, I am subject to punishment. 172-174 Main Street LLC Applicant’s Signature: By: Date: July 8, 2024 Maurice Cox, Managing Member CONTINUANCE Should the Planning Board/Zoning Board of Adjustment have a full and heavy agenda, or discussion and meeting regarding this application requiring carrying the matter past the statue time limit, the applicant grants permission for such an extension. 172-174 Main Street LLC Applicant’s Signature: By: Date: _July 8, 2024 Maurice Cox, Managing Member OWNER’S AUTHORIZATION — MUST BE SIGNED I hereby certify that I reside at maintain in the County of and the State of 3 and that is the owner of all that certain lot, piece or parcel of land known as Block(s)____ Lot(s) on the Tax Map of. which property is the subject of the above application, and that said application is hereby authorized by me. Furthermore, I authorize inspection of the site which is the subject of this application, Owner’s Signature Date: THIS APPLICATION DOES NOT RELIEVE THE APPLICANT FROM COMPLYING WITH OTHER TOWNSHIP ORDINANCES SUCH AS THE TREE REMOVAL ORDINANCE AND OBTAINING THE NECESSARY APPROVALS AND PERMITS UNDER SUCH ORDINANCES.